Doctoral Dissertation Research: Death and Survival in a Pandemic: A Bioarchaeological Investigation of Frailty and Resilience

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This dissertation explores how human biological variation influenced the risk of death and survival in a major influenza pandemic. The researchers examine human skeletal remains of people who died during an influenza pandemic to understand how frailty (defined as the increased likelihood of disease and death) and resilience impacted the risk of mortality. In addition to increasing scientific knowledge of biological vulnerability, this project will help researchers understand how social norms create inequalities that directly impact health and mortality. The researchers will collect public health data on underrepresented groups, creating valuable information on how influenza incidence and severity may vary in marginalized populations. This project will therefore contribute to the goals of Healthy People 2020, a government initiative to improve the health of all Americans. This project will identify risk factors that increased a person’s risk of dying in a past influenza pandemic, helping scientists predict how a future influenza outbreak may affect modern populations. This research will provide a female first-generation college student with training in a STEM field, laboratory methods, and statistics, as well as additional opportunities for her to collaborate with scholars in other fields.It seems obvious that a person who is frail should always be more likely to die than someone who is healthy and resilient. However, during the Spanish Influenza pandemic of 1918, young adults between the ages of 20-40 were among the most likely to die. There are many theories as to why seemingly healthy young adults died in record numbers during this pandemic, however no one has questioned whether the young people were actually healthy. Was there some underlying frailty in these individuals or was the pandemic truly killing resilient people? This project will explore the factors that influenced mortality and survival in the 1918 pandemic by answering the following questions: 1) Were frail individuals more likely to die during the Spanish Influenza pandemic? 2) Were more resilient individuals more likely to survive the Spanish Influenza pandemic? 3) Do demographic factors such as age, sex, and race influence frailty and resilience? Human skeletal remains from the Hamann-Todd collection, an assemblage of individuals who died in Cleveland, Ohio, during the 1918 pandemic will be examined for skeletal markers of frailty and resilience. These data will be analyzed using a type of statistical analyses called hazards analysis that shows how the risk of death changes over time in response to certain circumstances. The results will show how the risk of death varied during the pandemic in individuals who were frail versus those who were resilient.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.